The fertility supplement market is enormous, and it makes enormous promises. Most of what is sold is not well-supported by clinical evidence. Here is a clear look at what the research actually shows, what is genuinely helpful, and what you can skip.
Strongly Recommended
Folate (400-800 mcg daily)
This is the one non-negotiable. Folate (or folic acid, the synthetic form) prevents neural tube defects in early fetal development. These defects form in the first few weeks of pregnancy, often before you know you are pregnant. Start taking it at least 1-3 months before trying to conceive.
Prenatal Vitamins
A good prenatal covers folate, iron, calcium, DHA, iodine, and other essentials that support both conception and early fetal development. If you are not taking one yet and are trying to conceive, start now. They are designed to cover the bases when diet alone may not.
Some Evidence
Vitamin D
Vitamin D deficiency is associated with reduced fertility. The first step is to get tested. If you are deficient, supplementing to a normal level makes sense. Random high-dose vitamin D without testing is not recommended.
CoQ10 (Coenzyme Q10)
CoQ10 may support egg quality, particularly for people over 35 or with diminished ovarian reserve. The research is promising but not definitive. Doses studied are typically 200-600 mg daily. Worth discussing with your doctor if you are in this category.
Omega-3 Fatty Acids (DHA/EPA)
Omega-3s support hormone production and may improve egg quality. Many prenatal vitamins include DHA. If yours does not, a fish oil or algae-based omega-3 supplement is a reasonable addition.
Iron
Important if you have heavy periods or are anemic. Most prenatals include some iron. If you have low iron or ferritin, your doctor may recommend a higher dose.
For Male Fertility
- Zinc: Supports sperm production and testosterone. Found in meat, shellfish, and legumes, or supplemented.
- Folate: Paired with zinc, some evidence for improving sperm quality and reducing DNA fragmentation.
- Antioxidants (vitamin C, E, selenium): May protect sperm from oxidative damage. Modest evidence for improvement in motility and morphology.
Skip or Be Cautious
- Herbs marketed as "fertility boosters" without clinical trial evidence (e.g. many "female fertility" blends)
- Mega-dose vitamins: more is not better, and some vitamins (like vitamin A) are harmful in excess during pregnancy
- Anything promising guaranteed pregnancy outcomes
The Bottom Line
Start with a quality prenatal vitamin, get your vitamin D tested, eat a varied and balanced diet, and talk to your doctor before adding anything else. The supplement market sells hope; what actually helps is evidence-based and usually simple.
Track Your Cycle While You Prepare
Understanding your cycle is one of the most useful things you can do while preparing for TTC. Bloom makes it private and easy.
Frequently Asked Questions
When should I start taking prenatal vitamins?
Ideally 1-3 months before trying to conceive. Folate is particularly important in the very early weeks of pregnancy, often before you know you are pregnant. Starting prenatals before you begin trying ensures you have adequate levels.
Can supplements replace a healthy diet for fertility?
No. Supplements fill nutritional gaps but cannot compensate for a poor overall diet. A varied diet with plenty of vegetables, whole grains, lean protein, and healthy fats forms the foundation. Supplements are additions, not replacements.
Are expensive specialty fertility supplements worth it?
Most of what you need is in a standard prenatal vitamin. Specialty supplements like CoQ10 may have some evidence for specific situations, but should be discussed with your doctor before adding them. Price does not equal effectiveness.